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  • Staging and prognosis of head and neck cancers

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    Staging

    Tests show whether you have a head and neck cancer and whether it has spread. Working out how far the cancer has spread is called staging. It helps your health care team recommend the best treatment for you.

    In Australia, the TNM system is the method most often used for staging head and neck cancers. TNM stands for tumour–nodes–metastasis. In this system, each letter is assigned a number to describe the cancer.

    Based on the TNM numbers, the doctor then works out the cancer’s overall stage (I–IV). Each head and neck cancer is staged slightly differently. In general, in stages I–II the cancer is small and hasn’t spread from the primary site (early head and neck cancer). In stages III–IV the cancer is larger and has spread to other parts of the body or the lymph nodes (advanced head and neck cancer). If you are finding it hard to understand staging, ask someone in your health care team to explain it in a way that makes sense to you.

    Prognosis

    Prognosis means the expected outcome of a disease. You may wish to discuss your prognosis and treatment options with your doctor, but it is not possible for anyone to predict the exact course of the disease. Instead, your doctor can give you an idea about the general prognosis for people with the same type and stage of cancer.

    To work out your prognosis, your doctor will consider:

    • your test results
    • the type of head and neck cancer
    • the tumour’s HPV status
    • the rate and depth of tumour growth
    • the likelihood of response to treatment
    • other factors such as your age, level of fitness and overall health.

    These factors will also help your doctor advise you on the best treatment options. Usually the earlier head and neck cancer is diagnosed, the better the outcome, but people with more advanced head and neck cancer may also respond well to treatment. 

    Which health professionals will I see?

    Your GP will arrange the first tests to assess your symptoms. If these tests do not rule out cancer, you will usually be referred to a specialist, who will arrange further tests. If head and neck cancer is diagnosed, the specialist will consider treatment options. Often these will be discussed with other health professionals at what is known as a multidisciplinary team (MDT) meeting. 

    During and after treatment, you will see a range of health professionals who specialise in different aspects of your care. It is recommended that complex head and neck cancer is treated in a specialist centre. Call Cancer Council 13 11 20 for information about specialist centres for head and neck cancer in your area. You can also ask Cancer Council about assistance that may be available if you have to travel a long way for treatment.

    This website page was last reviewed and updated January 2020.

    Information reviewed by: A/Prof David Wiesenfeld, Oral and Maxillofacial Surgeon, Director, Head and Neck Tumour Stream, The Victorian Comprehensive Cancer Centre at Melbourne Health, VIC; Alan Bradbury, Consumer; Dr Ben Britton, Senior Clinical and Health Psychologist, John Hunter Hospital, NSW; Dr Madhavi Chilkuri, Radiation Oncologist, Townsville Cancer Centre, The Townsville Hospital, QLD; Jedda Clune, Senior Dietitian (Head and Neck Cancer), Sir Charles Gairdner Hospital, WA; Dr Fiona Day, Staff Specialist, Medical Oncology, Calvary Mater Newcastle, and Conjoint Senior Lecturer, The University of Newcastle, NSW; Dr Ben Dixon, ENT, Head and Neck Surgeon, Peter MacCallum Cancer Centre and St Vincent’s Hospital Melbourne, VIC; Emma Hair, Senior Social Worker, St George Hospital, NSW; Rosemerry Hodgkin, 13 11 20 Consultant, Cancer Council WA; Kara Hutchinson, Head and Neck Cancer Nurse Coordinator, St Vincent’s Hospital Melbourne, VIC; A/Prof Julia Maclean, Speech Pathologist, St George Hospital, NSW; Prof Jane Ussher, Chair, Women’s Health Psychology, Translational Health Research Institute (THRI), School of Medicine, Western Sydney University, NSW; Andrea Wong, Physiotherapist, St Vincent’s Hospital Melbourne, VIC.

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